[The value of intravaginal ultrasonography of the cervix uteri for evaluation of the risk of premature labor].
OBJECTIVE
To determinate the predictive value of cervical length, measured by transvaginal ultrasound, for preterm delivery among patients with signs of preterm labor.


METHODS
Department of Gynecology & Obstetrics, Poissy Hospital Center.


METHODS
A prospective study that measured cervical length by transvaginal ultrasound was performed among 108 patients with a singleton pregnancy hospitalized with signs of premature labor between 24 and 34 weeks' gestation or within 21 days of inclusion.


RESULTS
The rate of preterm birth was 22.2% (24/108). When cervical length was < or = 26 mm, the gestational age at delivery was significantly lower that when it exceeded 26 mm (36.3 +/- 3.0 weeks compared with 38.5 +/- 2.1 weeks; p < 0.0001). 40.4% (19/47) of patients whose cervical length was < or = 26 mm gave birth prematurely, compared with only 8.2% (5/61) of those with a cervix > 26 mm The sensitivity, specificity, positive predictive value, and negative predictive value of transvaginal ultrasonography were, respectively, 79.2, 66.6, 40.4, and 91.8% for delivery before 37 weeks' gestation, and 75.0, 62.0, 25.5, and 93.4% for delivery within 21 days of the ultra-sound measurement.


CONCLUSIONS
Transvaginal ultrasound of the cervix provides an objective method for evaluating the risk of preterm delivery. Its predictive values are impressive and allow better discrimination between women at high risk of preterm delivery and those in false preterm labor.
Goffinet
F
F
Service de Gynécologie et Obstétrique, Centre Hospitalier Intercommunal, Poissy.
Rozenberg
P
P
Kayem
G
G
Perdu
M
M
Philippe
H J
HJ
Nisand
I
I
D000328:Adult; D002584:Cervix Uteri / Q000000981:diagnostic imaging* / Q000503:physiopathology; D036861:Delivery, Obstetric; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000000981:diagnostic imaging; D005544:Forecasting; D005865:Gestational Age; D006406:Hematoma / Q000000981:diagnostic imaging; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007752:Obstetric Labor, Premature / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D010922:Placenta Diseases / Q000000981:diagnostic imaging; D010923:Placenta Previa / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal; D014621:Vagina
Intérêt de l'échographie endovaginale du col utérin pour l'évaluation du risque d'accouchement prématuré.